Advice to the people in general, with regard to their health

by S. A. D. Tissot

Even those among them who are more prudent, who preserve their Morals, and make some Savings, being accustomed to a City Life, and dreading the Labour of a Country one (of the Regulation of which they are also ignorant) chuse to become little Merchants, or Tradesmen; and this must be a Drawback from Population, as any Number of Labourers beget more Children than an equal Number of Citizens; and also by Reason, that out of any given Number, more Children die in Cities, than in the Country.

The same Evils also prevail, with Regard to female Servants. After ten or twelve Years Servitude, the Maid-Servants in Cities cannot acquit themselves as good Country Servants: and such of them as chuse this Condition, quickly fail under that Kind or Quantity of Work, for which they are no longer constituted. Should we see a Woman married in the Country, a Year after leaving Town, it is easy to observe, how much that Way of living in the Country has broke her. Frequently their first Child-bed, in which Term they have not all the Attendance their Delicacy demands, proves the Loss of their Health; they remain in a State of Languor, of Feebleness, and of Decay: they have no more Children; and this renders their Husbands unuseful towards the Population of the State.

Abortions, Infants carried out of their Country after a concealed Pregnancy, and the Impossibility of their getting Husbands afterwards, are frequently the Effects of their Libertinage.

It is to be apprehended too these bad Effects are rather increasing with us; since, either for want of sufficient Numbers, or from oeconomical Views, it has become a Custom, instead of Women Servants, to employ Children, whose Manners and whole Constitutions are not yet formed; and who are ruined in the same Manner, by their Residence in Town, by their Laziness, by bad Examples, and bad Company.

Doubtless much remains still unsaid on these important Heads; but besides my Intention not to swell this Treatise immoderately, and the many Avocations, which prevent me from launching too far into what may be less within the Bounds of Medicine, I should be fearful of digressing too far from my Subject. What I have hitherto said however, I think cannot be impertinent to it; since in giving Advice to the People, with Regard to their Health, it was necessary to display to them the Causes that impaired it: though what I might be able to add further on this Head, would probably be thought more remote from the Subject.

I shall add then but a single Hint on the Occasion. Is it not practicable, in Order to remedy those Evils which we cannot prevent, to select some particular Part or Canton of the Country, wherein we should endeavour by Rewards, 1st. Irremoveably to fix all the Inhabitants. 2dly. To encourage them by other Rewards to a plentiful and legitimate Increase. They should not be permitted to go out of it, which must prevent them from being exposed to the Evils I have mentioned. They should by no means intermarry with any Strangers, who might introduce such Disorders among them. Thus very probably this Canton, after a certain Time, would become even over-peopled, and might send out Colonies to the others.

One Cause, still more considerable than those we have already mention'd, has, to this very Moment, prevented the Increase of the People in France. This is the Decay of Agriculture. The Inhabitants of the Country, to avoid serving in the Militia; to elude the Days-Service impos'd by their Lords, and the Taxes; and being attracted to the City by the Hopes of Interest, by Laziness and Libertinage, have left the Country nearly deserted. Those who remain behind, either not being encouraged to work, or not being sufficient for what there is to do, content themselves with cultivating just as much as is absolutely necessary for their Subsistence. They have either lived single, or married but late; or perhaps, after the Example of the Inhabitants of the Cities, they have refused to fulfil their Duty to Nature, to the State, and to a Wife. The Country deprived of Tillers, by this Expatriation and Inactivity, has yielded nothing; and the Depopulation of the State has daily increased, from the reciprocal and necessary Proportion between Subsistence and Population, and because Agriculture alone can increase Subsistence. A single Comparison will sufficiently evince the Truth and the Importance of these Principles, to those who have not seen them already divulged and demonstrated in the Works of the [⁶] Friend of Man.

“An old Roman, who was always ready to return to the Cultivation of his Field, subsisted himself and his Family from one Acre of Land. A Savage, who neither sows nor cultivates, consumes, in his single Person, as much Game as requires fifty Acres to feed them. Consequently Tullus Hostilius, on a thousand Acres, might have five thousand Subjects: while a Savage Chief, limited to the same Extent of Territory, could scarcely have twenty: such an immense Disproportion does Agriculture furnish, in Favour of Population. Observe these two great Extremes. A State becomes dispeopled or peopled in that Proportion, by which it recedes from one of these Methods, and approaches to the other.” Indeed it is evident, that wherever there is an Augmentation of Subsistence, an Increase of Population will soon follow; which again will still further facilitate the Increase of Provisions. In a State thus circumstanced Men will abound, who, after they have furnished sufficient Numbers for the Service of War, of Commerce, of Religion, and for Arts and Professions of every kind, will further also furnish a Source for Colonies, who will extend the Name and the Prosperity of their Nation to distant Regions. There will ensue a Plenty of Commodities, the Superfluity of which will be exported to other Countries, to exchange for other Commodities, that are not produced at home; and the Balance, being received in Money, will make the Nation rich, respectable by its Neighbours, and happy. Agriculture, vigorously pursued, is equal to the Production of all these Benefits; and the present Age will enjoy the Glory of restoring it, by favouring and encouraging Cultivaters, and by forming Societies for the Promotion of Agriculture.

I proceed at length to the fourth Cause of Depopulation, which is the Manner of treating sick People in the Country. This has often affected me with the deepest Concern. I have been a Witness, that Maladies, which, in themselves, would have been gentle, have proved mortal from a pernicious Treatment: I am convinced that this Cause alone makes as great a Havock as the former; and certainly it requires the utmost Attention of Physicians, whose Duty it is to labour for the Preservation of Mankind. While we are employing our assiduous Cares on the more polished and fashionable Part of them in Cities, the larger and more useful Moiety perish in the Country; either by particular, or by highly epidemical, Diseases, which, within a few Years past, have appeared in different Villages, and made no small Ravages. This afflicting Consideration has determined me to publish this little Work, which is solely intended for those Patients, who, by their Distance from Physicians, are deprived of their Assistance. I shall not give a Detail of my Plan, which is very simple, in this Part; but content myself with affirming, I have used my utmost Care to render it the most useful I possibly could: and I dare hope, that if I have not fully displayed its utmost Advantages, I have at least sufficiently shewn those pernicious Methods of treating Diseases, that should incontestably be avoided. I am thoroughly convinced, the Design might be accomplished more compleatly than I have done it; but those who are so capable of, do not attempt, it: I happen to be less timid; and I hope that thinking Persons will rather take it in good part of me, to have published a Book, the composing of which is rather disagreeable from its very Facility; from the minute Details, which however are indispensable; and from the Impossibility of discussing any Part of it (consistently with the Plan) to the Bottom of the Subject; or of displaying any new and useful Prospect. It may be compared, in some Respects, to the Works of a spiritual Guide, who was to write a Catechism for little Children.

At the same time I am not ignorant there have already been a few Books calculated for Country Patients, who are remote from Succour: but some of these, tho' published with a very good Purpose, produce a bad Effect. Of this kind are all Collections of Receipts or Remedies, without the least Description of the Disease; and of Course without just Directions for the Exhibition, or Application, of them. Such, for Example, is the famous Collection of Madam Fouquet, and some more in the same manner. Some others approach towards my Plan; but many of them have taken in too many Distempers, whence they are become too voluminous. Besides, they have not dwelt sufficiently upon the Signs of the Diseases; upon their Causes; the general Regimen in them, and the Mismanagement of them. Their Receipts are not generally as simple, and as easy to prepare, as they ought to be. In short, the greater Part of their Writers seem, as they advanced, to have grown tired of their melancholy Task, and to have hurried them out too expeditiously. There are but two of them, which I must name with Respect, and which being proposed on a Plan very like my own, are executed in a superior Manner, that merits the highest Acknowlegements of the Publick. One of these Writers is M. Rosen, first Physician of the Kingdom of Sweden; who, some Years since, employed his just Reputation to render the best Services to his Country Men. He has made them retrench from the Almanacs those ridiculous Tales; those extraordinary Adventures; those pernicious astrological Injunctions, which there, as well as here, answer no End, but that of keeping up Ignorance, Credulity, Superstition, and the falsest Prejudices on the interesting Articles of Health, of Diseases, and of Remedies. He has also taken Care to publish simple plain Treatises on the most popular Distempers; which he has substituted in the Place of the former Heap of Absurdities. These concise Works however, which appear annually in their Almanacs, are not yet translated from the Swedish, so that I was unqualified to make any Extracts from them. The other is the Baron Van Swieten, first Physician to their Imperial Majesties, who, about two Years since, has effected for the Use of the Army, what I now attempt for sick People in the Country. Though my Work was greatly advanced, when I first saw his, I have taken some Passages from it: and had our Plans been exactly alike, I should imagine I had done the Publick more Service by endeavouring to extend the Reading of his Book, than by publishing a new one. Nevertheless, as he is silent on many Articles, of which I have treated diffusively; as he has treated of many Distempers, which did not come within my Plan; and has said nothing of some others which I could not omit; our two Works, without entering into the Particulars of the superior Merit of the Baron's, are very different, with Regard to the Subject of the Diseases; tho' in such as we have both considered, I account it an Honour to me to find, we have almost constantly proceeded upon the same Principles.